CANNON MEMORIAL HOSPITAL (NPI# 1700890084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700890084 |
| Entity Type | Organization |
| Organization Name | CANNON MEMORIAL HOSPITAL |
| Other Organization Name | ANMED HEALTH CANNON EASTSIDE FAMILY PRACTICE |
| Practice Address |
111 W Roper Rd Easley SC 29640-8805 |
| Mailing Address |
Po Box 919 Pickens SC 29671-0919 |
| Practice Telephone | 8648978280 |
| Practice Fax Number | 8648978281 |
| Mailing Telephone | 8648978286 |
| Mailing Fax Number | 8648780035 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | BRANDON CLARY (PRESIDENT/CEO) |
| Authorized Official Telephone | 8648981133 |
| Is Organization Subpart | Y |
| Parent Organization Name | CANNON MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4560 | 05 | |
| SC | RHC171 | 05 |
| Other Name | Type Code |
|---|---|
| AnMed Health Cannon Eastside Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629215298 | Cannon Memorial Hospital | Orthopaedic Surgery | 3722 Clemson Blvd, Suite A, Anderson, SC 29621-1317 | 2009-01-19 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1457427494 | Cannon Memorial Hospital | Surgery | 123 Wg Acker Dr Ste D, Pickens, SC 29671-2739 | 2006-11-28 |
| 1497744254 | Cannon Memorial Hospital | General Acute Care Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 | 2005-10-14 |
| 1295267227 | Cannon Memorial Hospital | Otolaryngology | 885 Tiger Blvd Ste A, Clemson, SC 29631-1480 | 2017-03-29 |
| 1902224876 | Cannon Memorial Hospital | Clinic/Center | 105 Liberty Blvd, Liberty, SC 29657-1641 | 2014-03-28 |
| 1861645558 | Cannon Memorial Hospital | Orthopaedic Surgery | 123 Wg Acker Dr, Suite C, Pickens, SC 29671-2739 | 2008-10-28 |
| 1497910772 | Cannon Memorial Hospital | Family Medicine | 865 Pendleton St, Pickens, SC 29671-2578 | 2008-07-25 |
| 1679738199 | Cannon Memorial Hospital | Orthopaedic Surgery | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2008-07-24 |
| 1861416216 | Cannon Memorial Hospital | Family Medicine | 123 Wg Acker Dr, Suite B, Pickens, SC 29671-2739 | 2006-07-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CANNON MEMORIAL HOSPITAL | 434 Hospital Dr, Linville, NC 28646 |
| Street Address |
111 W ROPER RD |
| City | EASLEY |
| State | SC |
| Zip Code | 29640-8805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245219401 | Margaret M Winbourn | Nurse Practitioner | 111 W Roper Rd, Easley, SC 29640-8805 | 2006-01-16 |
| 1558843664 | Heather Renee Turner | Nurse Practitioner | 111 W Roper Rd, Easley, SC 29640-8805 | 2018-09-05 |
| 1437345675 | Trang D Lusk | Nurse Practitioner | 111 W Roper Rd, Easley, SC 29640-8805 | 2007-09-21 |
| 1740294305 | Robert Goodwin Person | Family Medicine | 111 W Roper Rd, Easley, SC 29640-8805 | 2006-07-28 |
| 1356393698 | Charles Richard Curry | Family Medicine | 111 W Roper Rd, Easley, SC 29640-8805 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063935773 | Mary Kathryn Henderson | Speech-Language Pathologist | 1400 Griffin Mill Road, Easley, SC 29640 | 2017-07-25 |
| 1417309451 | Ashby Park Pediatric Dentistry Easley | Dentist | 708 North A Street, Easley, SC 29640 | 2016-07-01 |
| 1548696990 | Phuong T Tran | Pharmacist | 309 Rolling Hills Circle, Easley, SC 29640 | 2013-09-17 |
| 1538593017 | Baptist Easley Hospital | Clinic/Center | 200 Fleet Wood Dr 3 Rd Floor, Easley, SC 29640 | 2013-09-03 |
| 1942507173 | Joanne Mason Wilkinson | Occupational Therapist | 1807a East Main St, Easley, SC 29640 | 2011-02-24 |
| 1861793911 | Ark Pharmacy Services LLC | Pharmacy | 5119- A Calhoun Memorial Hwy, Easley, SC 29640 | 2010-11-05 |
| 1659507952 | Sarah Elizabeth Proulx | Dentist | 227 South Pendleton Street, Suita A, Easley, SC 29640 | 2009-06-02 |
| 1508030503 | Jean Claire Palmour | Massage Therapist | 404 South Fifth Street, Jj & Company Salon & Spa, Easley, SC 29640 | 2008-04-22 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1942419171 | William Kent Hammond | Dentist | 298 Enterprise Dr, Easley, SC 29640 | 2007-05-22 |
| Find all providers in zip 29640 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1114204153 | Mcleod Physician Associates II | Clinic/Center | 5260 Highway 9, Green Sea, SC 29545-4930 | 2011-11-04 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.